=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053746909
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAULIN PATEL PHARM.D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2013
-----------------------------------------------------
Last Update Date | 09/11/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1509 ROUTE 38
-----------------------------------------------------
City | CHERRY HILL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08002-2271
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-663-1021
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1100 NEWPORTVILLE RD APT 515
-----------------------------------------------------
City | CROYDON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19021-5055
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-271-6312
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 28RI03450000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP447628
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------